. Etiology 
 A.

Predisposing factors for bacterial conjunctivitis, especially epidemic

forms, are flies, poor hygienic conditions, hot dry climate, poor sanitation and dirty
habits. These factors help the infection to establish, as the disease is highly
contagious. 
 B. Causative organisms. It may be caused by a wide range of
organisms in the following approximate order of frequency : 


_ Staphylococcus aureus is the most common cause 
 of bacterial

conjunctivitis and blepharo- 
 conjunctivitis. 


_ Staphylococcus epidermidis is an innocuous flora 
 of lid and

conjunctiva. It can also produce 
 blepharoconjunctivitis. 


_ Streptococcus pneumoniae (pneumococcus) 
 produces acute

conjunctivitis usually associated with petechial subconjunctival
haemorrhages. The disease has a self-limiting course of 9-10 days. 


_Streptococcus pyogenes (haemolyticus) is virulent and usually

produces pseudomembranous conjunctivitis. 


_ Haemophilus influenzae (aegyptius, Koch- Weeks bacillus). It

classically causes epidemics of mucopurulent conjunctivitis, known as ‘red-
eye’ especially in semitropical countries. 


. _ Moraxella lacunate (Moraxella Axenfeld bacillus) is most common cause of

angular conjunctivitis and angular blepharoconjunctivitis.
. _ Pseudomonas pyocyanea is a virulent organism. It readily invades the cornea.
. _ Neisseria gonorrhoeae typically produces acute purulent conjunctivitis in adults
and ophthalmia neonatorum in new born. It is capable of invading intact corneal
epithelium.
. _ Neisseria meningitidis (meningococcus) may produce mucopurulent
conjunctivitis.
. _ Corynebacterium diphtheriae causes acute membranous conjunctivitis. Such
infections are rare now-a-days.